Seminars in Hematology
Volume 46 , Pages S33-S36 , January 2009

Recognizing and Treating Secondary Immune Thrombocytopenic Purpura Associated With Lymphoproliferative Disorders

  • Howard A. Liebman

      Affiliations

    • Corresponding Author InformationAddress correspondence to Howard A. Liebman, MD, Norris Cancer Hospital, Room 3466, 1441 Eastlake Ave, Los Angeles, CA 90033

References 

  1. Kuznetsov AI, Ivanov AL, Idelson LI, Mazurov AV. Mechanisms of thrombocytopenia in patients with lymphoproliferative diseases. Eur J Haematol. 1992;49:113–118
  2. Berkman AW, Kickler T, Braine H. Platelet-associated IgG in patients with lymphoma. Blood. 1984;63:944–948
  3. Rubinstein DB, Longo DL. Peripheral destruction of platelets in chronic lymphocytic leukemia: recognition, prognosis and therapeutic implications. Am J Med. 1981;71:729–732
  4. Binet JL, Auquier A, Dighiero G, Chastang C, Piguet H, Goasguen J, et al. A new prognostic classification of chronic lymphocytic leukemia derived from a multivariate survival analysis. Cancer. 1981;48:198–206
  5. Rai KR, Sawitsky A, Cronkite EP, Chanana AD, Levy RN, Pasternack BS. Clinical staging of chronic lymphocytic leukemia. Blood. 1975;46:219–234
  6. Carey RW, McGinnis A, Jacobson BM, Carvalho A. Idiopathic thrombocytopenic purpura complicating chronic lymphocytic leukemia. Arch Intern Med. 1976;136:62–66
  7. Kaden BR, Rosse WF, Hauch TW. Immune thrombocytopenia in lymphoproliferative diseases. Blood. 1979;53:545–551
  8. Lim SH, Ifthikharuddin JJ. Autoimmune thrombocytopenic purpura complicating lymphoproliferative disorders. Leuk Lymphoma. 1994;15:61–64
  9. Duhrsen U, Augener W, Zwingers T, Brittinger G. Spectrum and frequency of autoimmune derangements in lymphoproliferative disorders: analysis of 637 cases and comparison with myeloproliferative diseases. Br J Haematol. 1987;67:235–239
  10. Hamblin TJ, Oscier DG, Young BJ. Autoimmunity in chronic lymphocytic leukaemia. J Clin Pathol. 1986;39:713–716
  11. Barcellini W, Capalbo S, Agostinelli RM, Mauro FR, Ambrosetti A, Calori R, et al. Relationship between autoimmune phenomena and disease stage and therapy in B-cell chronic lymphocytic leukemia. Haematologica. 2006;91:1689–1692
  12. Visco C, Ruggeri M, Laura EM, et al. Impact of immune thrombocytopenia on the clinical course of chronic lymphocytic leukemia. Blood. 2008;111:1110–1116
  13. Mittal S, Blaylock MG, Culligan DJ, Barker RN, Vickers MA. A high rate of CLL phenotype lymphocytes in autoimmune hemolytic anemia and immune thrombocytopenic purpura. Haematologica. 2008;93:151–152
  14. Hedge UM, Zuiable A, Ball S, Roter BL. The relative incidence of idiopathic and secondary autoimmune thrombocytopenia: a clinical and serological evaluation in 508 patients. Clin Lab Haematol. 1985;7:7–16
  15. Xiros N, Binder T, Anger B, Bohlke J, Heimpel H. Idiopathic thrombocytopenic purpura and autoimmune hemolytic anemia in Hodgkin's disease. Eur J Haematol. 1988;40:437–441
  16. Dhodapkar MV, Li CY, Lust JA, Tefferi A, Phyliky RL. Clinical spectrum of clonal proliferations of T-large granular lymphocytes: a T-cell clonopathy of undetermined significance?. Blood. 1994;84:1620–1627
  17. Hegde UP, Wilson WH, White T, Cheson BD. Rituximab treatment of refractory fludarabine-associated immune thrombocytopenia in chronic lymphocytic leukemia. Blood. 2002;100:2260–2262
  18. Zaja F, Vianelli N, Sperotto A, Patriarca F, Tani M, Marin L, et al. Anti-CD20 therapy for chronic lymphocytic leukemia-associated autoimmune diseases. Leuk Lymphoma. 2003;44:1951–1955
  19. Gupta N, Kavuru S, Patel D, Janson D, Driscoll N, Ahmed S, et al. Rituximab-based chemotherapy for steroid-refractory autoimmune hemolytic anemia of chronic lymphocytic leukemia. Leukemia. 2002;16:2092–2095
  20. Ammatuna E, Marino C, Mitra ME, Calvaruso G, Iannitto E. Successful treatment of steroid resistant autoimmune thrombocytopenia associated with chronic lymphocytic leukemia with alemtuzumab. Eur J Haematol. 2004;73:225–226
  21. Pangalis GA, Dimopoulou MN, Angelopoulou MK, Tsekouras C, Vassilakopoulos TP, Vaiopoulos G, et al. Campath-1H (anti-CD52) monoclonal antibody therapy in lymphoproliferative disorders. Med Oncol. 2001;18:99–107
  22. Rudders RA, Aisenberg AC, Schiller AL. Hodgkin's disease presenting as “idiopathic” thrombocytopenic purpura. Cancer. 1972;30:220–230
  23. Bradley SJ, Hudson GV, Linch DC. Idiopathic thrombocytopenic purpura in Hodgkin's disease: a report of eight cases. Clin Oncol (R Coll Radiol). 1993;5:355–357
  24. Martinelli G, Zinzani PL, Magagnoli M, Vianelli N, Tura S. Incidence and prognostic significance of idiopathic thrombocytopenic purpura in patients with Hodgkin's disease in complete hematological remission. Haematologica. 1998;83:669–670
  25. Landgren O, Engels EA, Pfeiffer RM, Gridley G, Mellemkjaer L, Olsen JH, et al. Autoimmunity and susceptibility to Hodgkin lymphoma: a population-based case-control study in Scandinavia. J Natl Cancer Inst. 2006;98:1321–1330
  26. Kirshner JJ, Zamkoff KW, Gottlieb AJ. Idiopathic thrombocytopenic purpura and Hodgkin's disease: report of two cases and a review of the literature. Am J Med Sci. 1980;280:21–28
  27. Cohen JR. Idiopathic thrombocytopenic purpura in Hodgkin's disease: a rare occurrence of no prognostic significance. Cancer. 1978;41:743–746
  28. Jones SE. Autoimmune disorders and malignant lymphoma. Cancer. 1973;31:1092–1098
  29. Wlodarski MW, O'Keefe C, Howe EC, Risitano AM, Rodriguez A, Warshawsky I, et al. Pathologic clonal cytotoxic T-cell responses: nonrandom nature of the T-cell-receptor restriction in large granular lymphocyte leukemia. Blood. 2005;106:2769–2780
  30. Kouides PA, Rowe JM. Large granular lymphocyte leukemia presenting with both amegakaryocytic thrombocytopenic purpura and pure red cell aplasia: clinical course and response to immunosuppressive therapy. Am J Hematol. 1995;49:232–236
  31. Ergas D, Tsimanis A, Shtalrid M, Duskin C, Berrebi A. T-gamma large granular lymphocyte leukemia associated with amegakaryocytic thrombocytopenic purpura, Sjogren's syndrome, and polyglandular autoimmune syndrome type II, with subsequent development of pure red cell aplasia. Am J Hematol. 2002;69:132–134
  32. Lai DW, Loughran TP, Maciejewski JP, Sasu S, Song SX, Epling-Burnette PK, et al. Acquired amegakaryocytic thrombocytopenia and pure red cell aplasia associated with an occult large granular lymphocyte leukemia. Leuk Res. 2008;32:823–827
  33. Ru J, Liebman HA. Successful treatment of refractory pure red cell aplasia associated with lymphoproliferative disorders with the anti-CD52 monoclonal antibody Alemtuzumab (CAMPATH-1H). Br J Haematol. 2003;123:278–281
  34. Straus SE, Sneller M, Lenardo MJ, Puck JM, Strober W. An inherited disorder of lymphocyte apoptosis: the autoimmune lymphoproliferative syndrome. Ann Intern Med. 1999;130:591–601
  35. Straus SE, Jaffe ES, Puck JM, Dale JK, Elkon KB, Rosen-Wolff A, et al. The development of lymphomas in families with autoimmune lymphoproliferative syndrome with germline Fas mutations and defective lymphocyte apoptosis. Blood. 2001;98:194–200
  36. Wei A, Cowie T. Rituximab responsive immune thrombocytopenic purpura in an adult with underlying autoimmune lymphoproliferative syndrome due to a splice-site mutation (IVS7+2 T>C) affecting the Fas gene. Eur J Haematol. 2007;79:363–366
  37. Rao VK, Dugan F, Dale JK, Davis J, Tretler J, Hurley JK, et al. Use of mycophenolate mofetil for chronic, refractory immune cytopenias in children with autoimmune lymphoproliferative syndrome. Br J Haematol. 2005;129:534–538
  38. Dimopoulou MN, Gandhi S, Ghevaert C, Chakraverty R, Fielding A, Webster D, et al. Successful treatment of autoimmune lymphoproliferative syndrome and refractory autoimmune thrombocytopenic purpura with a reduced intensity conditioning stem cell transplantation followed by donor lymphocyte infusion. Bone Marrow Transplant. 2007;40:605–606
  39. Teachey DT, Obzut DA, Axsom K, Choi JK, Goldsmith KC, Hall J, et al. Rapamycin improves lymphoproliferative disease in murine autoimmune lymphoproliferative syndrome (ALPS). Blood. 2006;108:1965–1971
  40. Sirolimus in autoimmune lymphoproliferative syndrome: a pilot series. clinicaltrials.gov/ct2/show/NCT00392951Accessed August 27, 2008

 STATEMENT OF CONFLICT OF INTEREST: Howard A. Liebman, MD, discloses the following: Consultant: Amgen, GSK, Bristol-Myers Squibb; Grant/Research: Amgen, GSK, Bristol-Myers Squibb.

PII: S0037-1963(08)00203-5

doi: 10.1053/j.seminhematol.2008.12.004

Seminars in Hematology
Volume 46 , Pages S33-S36 , January 2009

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